Troy Historic Village Membership Form

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is this membership a gift?*

No, this membership is for me and/or my family!Yes! I am purchasing this Membership as a gift for someone else.

Gift Recipient Name

First NameLast Name

Gift Recipient Email

example@example.com

Gift Recipient Phone Number

Please enter a valid phone number.

Gift Recipient Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

New or existing membership?*

New memberRenewing member

Select the Membership level you'd like to purchase:*

Individual Membership - One Year

Membership for one adult (age 18 or older). Membership begins on date of purchase and is valid for one year from date of purchase.

$35.00

Individual Membership - Two Years

Membership for one adult (age 18 or older). Membership begins on date of purchase and is valid for two years from date of purchase.

$60.00

Household Membership - One Year

Membership for up to six adults and/or children. Membership begins on date of purchase and is valid for one year from date of purchase.

$55.00

Household Membership - Two Years

Membership for up to six adults and/or children. Membership begins on date of purchase and is valid for two years from date of purchase.

$90.00

Patron Membership - One Year

Membership for up to six adults and/or children. Membership begins on date of purchase and is valid for one year from date of purchase.

$150.00

Patron Membership - Two Years

Membership for up to six adults and/or children. Membership begins on date of purchase and is valid for two years from date of purchase.

$250.00

Barnard Benefactor - One Year

Membership for up to ten adults and/or children. Membership begins on date of purchase and is valid for one year from date of purchase.

$350.00

Barnard Benefactor - Two Years

Membership for up to ten adults and/or children. Membership begins on date of purchase and is valid for two years from date of purchase.

$600.00

Business Membership - One Year

Please review Business Membership benefits on our website. Membership begins on date of purchase and is valid for one year from date of purchase.

$1,000.00

Total

$0.00

Primary Card Holder's Name:

Tell us more about your household. Up to (5) additional people can use your membership benefits. Who would you like to include on your membership?

Rows	Name	Relationship to Primary Card Holder
Additional Card Holder #2 (First & Last Name)
Additional Card Holder #3 (First & Last Name)
Additional Card Holder #4 (First & Last Name)
Additional Card Holder #5 (First & Last Name)
Additional Card Holder #6 (First & Last Name)

Tell us more about your household. Up to (9) additional people can use your membership benefits. Who would you like to include on your membership?

Rows	Name	Relationship to Primary Card Holder
Additional Card Holder #2 (First & Last Name)
Additional Card Holder #3 (First & Last Name)
Additional Card Holder #4 (First & Last Name)
Additional Card Holder #5 (First & Last Name)
Additional Card Holder #6 (First & Last Name)
Additional Card Holder #7 (First & Last Name)
Additional Card Holder #8 (First & Last Name)
Additional Card Holder #9 (First & Last Name)
Additional Card Holder #10 (First & Last Name)

Business Name

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Troy Historic Village Membership Form

Enter your contact information

Select your membership package

Please enter your payment information and click submit to complete your registration. Your membership purchase will not be finalized until payment is complete.